Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jun 19;6(2):69.
doi: 10.3390/healthcare6020069.

A Community Study of Borrelia burgdorferi Antibodies among Individuals with Prior Lyme Disease in Endemic Areas

Barbara Strobino  1   2 , Katja Steinhagen  3 , Wolfgang Meyer  4 , Thomas Scheper  5 , Sandra Saschenbrecker  6 , Wolfgang Schlumberger  7 , Winfried Stöcker  8 , Andrea Gaito  9 , Brian A Fallon  10
Affiliations

A Community Study of Borrelia burgdorferi Antibodies among Individuals with Prior Lyme Disease in Endemic Areas

Barbara Strobino et al. Healthcare (Basel). .

Abstract

The objective was to examine the prevalence of Borrelia antibodies among symptomatic individuals with recent and past Lyme disease in endemic communities using standard assays and novel assays employing next-generation antigenic substrates. Single- and two-tiered algorithms included different anti-Borrelia ELISAs and immunoblots. Antibody prevalence was examined in sera from 32 individuals with recent erythema migrans (EM), 335 individuals with persistent symptoms following treatment for Lyme disease (PTLS), and 41 community controls without a history of Lyme disease. Among convalescent EM cases, sensitivity was highest using the C6 ELISA (93.8%) compared to other single assays; specificity was 92.7% for the C6 ELISA vs. 85.4⁻97.6% for other assays. The two-tiered ELISA-EUROLINE IgG immunoblot combinations enhanced case detection substantially compared to the respective ELISA-IgG Western blot combinations (75.0% vs. 34.4%) despite similar specificity (95.1% vs. 97.6%, respectively). For PTLS cohorts, two-tier ELISA-IgG-blot positivity ranged from 10.1% to 47.4%, depending upon assay combination, time from initial infection, and clinical history. For controls, the two-tier positivity rate was 0⁻14.6% across assays. A two-tier algorithm of two-ELISA assays yielded a high positivity rate of 87.5% among convalescent EM cases with specificity of 92.7%. For convalescent EM, combinations of the C6 ELISA with a second-tier ELISA or line blot may provide useful alternatives to WB-based testing algorithms.

Keywords: Borrelia burgdorferi; ELISA; Lyme disease; immunoblot; serology.

PubMed Disclaimer

Conflict of interest statement

K.S., W.M., T.S. and S.S. are employees of Euroimmun. W.S. (Wolfgang Schlumberger) and W.S. (Winfried Stöcker) are board members of Euroimmun. The other authors declared that they have no conflict of interest.

Figures

Figure 1
Figure 1
Anti-Borrelia immunoblot tests. Representative reactivity of the WB/VlsE IgG and WB IgM after incubation with sera from patients with late Lyme disease (IgG) and erythema migrans (IgM), respectively (left two panels). Schematic representation of antigens used in the line blot assays EUROLINE-RN-AT IgG and EUROLINE-RN-AT IgM (right two panels).
See this image and copyright information in PMC

References

    1. Nelson C.A., Saha S., Kugeler K.J., Delorey M.J., Shankar M.B., Hinckley A.F., Mead P.S. Incidence of clinician-diagnosed Lyme disease, United States, 2005–2010. Emerg. Infect. Dis. 2015;21:1625–1631. doi: 10.3201/eid2109.150417. - DOI - PMC - PubMed
    1. Sykes R.A., Makiello P. An estimate of Lyme borreliosis incidence in Western Europe. J. Public Health. 2017;39:74–81. doi: 10.1093/pubmed/fdw017. - DOI - PubMed
    1. Wormser G.P., Dattwyler R.J., Shapiro E.D., Halperin J.J., Steere A.C., Klempner M.S., Krause P.J., Bakken J.S., Strle F., Stanek G., et al. The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: Clinical practice guidelines by the Infectious Diseases Society of America. Clin. Infect. Dis. 2006;43:1089–1134. doi: 10.1086/508667. - DOI - PubMed
    1. Wilske B., Fingerle V., Schulte-Spechtel U. Microbiological and serological diagnosis of Lyme borreliosis. FEMS Immunol. Med. Microbiol. 2007;49:13–21. doi: 10.1111/j.1574-695X.2006.00139.x. - DOI - PubMed
    1. Stanek G., Strle F. Lyme borreliosis. Lancet. 2003;362:1639–1647. doi: 10.1016/S0140-6736(03)14798-8. - DOI - PubMed

LinkOut - more resources